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CYP2D6 Drug Metabolism Gene Test

Illinois rates for HCPCS 81226

Examines the CYP2D6 gene, which carries the instructions for a liver enzyme that breaks down a large share of common medicines. The test checks for the usual variants, including extra or missing copies of the gene, and reports whether a person clears those drugs slowly, normally, or unusually fast.

Rates data updated July 2026.

How much does CYP2D6 Drug Metabolism Gene Test cost?

$372

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $372 for this service. The price depends on where it is billed: about $347 from a physician practice, and about $708 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$347$245 to $389
FacilityA hospital or hospital-owned outpatient department$708$457 to $933

How much rates vary

Facilitymedian $708 · 10th to 90th $372 to $1,230Professionalmedian $347 · 10th to 90th $3 to $776
$10.0$100.0$1.0Kfacility $708professional $347

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$707.95
Typical High
$933.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$371.54
Typical High
$831.76
BCBS
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$1,584.89
Typical High
$5,623.41
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$309.03
Typical High
$346.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$954.99
Typical High
$2,089.30
Cigna
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$549.54
Typical High
$758.58
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$794.33
Typical High
$1,288.25
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$588.84
United
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$912.01
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$269.15
Typical High
$446.68

Where Illinois sits

The same service costs 3.8 times more in Alaska than in Vermont. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Illinois $372 · 40th of 51
AK $1,023VT $269

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.